Ventricular Tachycardia

An episode of Ventricular Tachycardia may be non-sustained (<30 seconds) or sustained. Sustained VT may terminate spontaneously, however, if not the patient may require a shock to the heart to return the rhythm to normal. During an episode of VT, a patient may be quite short of breath, may develop chest pain, may pass out, and may even die. During an episode of VT, it is important that one seek immediate medical attention.

The therapy of VT varies greatly depending on the etiology of the VT. As discussed, there are many different conditions of the heart which may lead to VT.

Unfortunately, VT in a patient with other heart conditions (such as congestive heart failure or long QT syndrome) may be terminal. If a patient such as this survives an episode of VT, most likely it will be recommended that the patient receive an implantable defibrillator. An implantable defibrillator will constantly monitor for future episodes of VT that may need to be treated with a shock to terminate the VT and prevent sudden death.

In a patient with a defibrillator, episodes of VT may require a defibrillator shock to prevent sudden death. Having frequent defibrillator discharges can greatly affect a patient’s quality of life and warrants further therapy to prevent episodes of VT.

In a patient with no other heart condition, VT is generally not terminal. However, a patient with VT may still have significant symptoms such as pounding in the chest, shortness of breath, or passing out. If episodes of VT recur, therapy to prevent VT may be warranted.

Learn more about Ventricular Tachycardia (VT).

Medical Therapy

Depending on the type of VT, a variety of medications may be appropriate. Such medications may include beta-blockers, calcium-channel blockers, or anti-arrhythmic medications such as amiodarone, sotalol, or mexiletine. The drugs have varying rates of effectiveness and are all associated with possible side effects. However, a trial of one or two medications is generally the first line therapy for patients with recurrent VT.

Catheter Ablation for VT

Catheter ablation for VT utilizing radiofrequency ablation (electrocautery injury) has developed over the last 30 years. With catheter ablation, a procedure is performed entirely with catheters inserted into the veins or arteries in the leg. It is a minimally invasive procedure. That is, no open heart surgery is needed. Overall cure rates with catheter ablation may vary from 50-95%, depending on the specific type of VT.

During a catheter ablation procedure, catheters (long wire electrodes) are advanced through the veins in the leg up to the heart.

Various measurements of the electrical system are performed. If a person is in normal rhythm at the time of the procedure, an attempt is made to reproduce the VT by pacing the heart through the catheters. Occasionally an intravenous medicine called isoproterenol is required to “rev up” the heart in order to reproduce the VT. Once the VT is reproduced, the specific type and location of origin of the VT can be diagnosed using the catheters in the heart.

Once the VT is diagnosed, to cure the VT, an ablation catheter is advanced to the heart. An ablation catheter is capable of delivering small radiofrequency lesions (electrocautery burns) on the order of 4-8 mm in diameter. These radiofrequency lesions have no long-term adverse consequences. Depending on the type of VT, these radiofrequency lesions are delivered in various locations of the heart.

Balloon Catheter
Occasionally, more complex diagnostic and ablation techniques are required for catheter ablation of VT.
balloon catheter

This may be the case particularly in patients with other heart problems or a history of heart surgery. In such situations, sophisticated 3-dimensional mapping techniques using a balloon catheter may be used to identify the location necessary to successfully ablate the VT.

Contact Us

Call the Heart & Vascular Center referral line at 866-862-4327 to find specialists, make an appointment or learn more about preventing heart disease.

Open Access is a new physician referral service, created by the UNC Center for Heart & Vascular Care, which coordinates all admissions and transfers through a single phone call and guarantees immediate acceptance for patients. Please contact us to learn more or call 866-862-4327.

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